Neck Solutions

Omega-3 Fatty Acid Supplements May Help Relieve Neck, Low Back Pain

From: Surg Neurol. 2006;65:326-331

More than 70 million NSAID prescriptions are written each year in the United States, and 30 billion over-the-counter NSAID tablets are sold annually with an estimate that 5% to 10% of the US population and 14% of elderly use this class of medication for pain control. NSAID-associated adverse effects affect up to 50% of users and 8% to 20% will have ulceration with 100 000 hospitalizations and a cost of 1.5 billion dollars for complications, according to the current authors.

Omega-3 EFAs found in fish and in pharmaceutical-grade fish oil supplements have as active ingredients EPA and DHA that can competitively inhibit the proinflammatory interleukins and may be useful for anti-inflammatory effects on joints. However, according to the current authors, the US Department of Agriculture has limited fish consumption to 1 serving weekly for children and pregnant women because of concerns about toxic contaminants in fish.

The authors selected omega-3 EFA as a fish oil supplement to examine its effect on pain and use of NSAIDs in patients with nonsurgical discogenic and arthritic neck and back pain presenting to a neurosurgical unit in a nonrandomized, non–placebo-controlled retrospective descriptive study.

Notes on Omega-3 Fatty Acid and relief of neck and low back pain

• Use of omega-3 EFA fish oil supplement at 2.4 g daily then 1.2 g daily for 4 weeks in patients with discogenic and arthritic neck and back pain is associated with improvement in subjective pain.
• Use of omega-3 EFA fish oil supplement for 4 weeks is associated with reduced use of NSAID in patients with nonsurgical neck and back pain, and no major adverse effects were reported, except loose bowels.

Omega-3 Fatty Acid and relief of neck and low back pain highlights

• 250 patients were evaluated for nonsurgical spine pain by one neurosurgeon, and the majority had degenerative disc disease with facet arthropathy in the lumbar or cervical spine.
• All were taking NSAIDs with 75% on cyclooxygenase-2 inhibitors.
• They were asked to take pharmaceutical-grade omega-3 EFAs at a dose of 2.4 g orally daily for 2 weeks then 1.2 g orally daily.
• The brand name of the supplement used for the study was not given.
• The omega-3 EFA consisted of EPA and DHA.
• Participants were asked to taper off their NSAIDs for 1 to 2 weeks after the initial 2 weeks.
• There was no placebo group, and participants were not randomized.
• One month later, participants were sent a questionnaire about subjective pain, adverse effects, and use of NSAIDs.
• Method of statistical analysis was not reported.
• Of 250 patients, 125 (50%) returned the questionnaire.
• Respondents spent an average of 75 days on fish oil.
• Mean age, sex, and other demographics of respondents and nonrespondents were not reported.
• 78% of respondents were taking 1.2 g, and 22% reported taking 2.4 g of omega-3 EFAs daily.
• Actual respondent adherence to supplements was not assessed or reported.
• 59% of respondents reported discontinuation of NSAID for pain control.
• 60% of respondents stated that their overall pain was improved vs before starting omega-3 EFAs.
• 80% of respondents stated that they were satisfied with the improvement in pain.
• 88% of respondents stated that they would continue to take omega-3 EFA.
• There were no significant adverse effects reported by respondents, except for loose bowel movements in 2 respondents.
• Potential differences between respondents and nonrespondents in use of omega-3 EFA, pain control, and use of NSAID response were not discussed.

The authors have disclosed they are stockholders in Inflammation Solutions, a dietary supplement retailer.